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U Köhler

Publications and source records attributed to U Köhler.

At least 73 records · Page 4Linked to original sources
PubMed1994

[Results of a case-control study of the current effect of various factors of cervical cancer risk. 2. Contraceptive behavior and the smoking factor].

We considered in this study 309 patients with cervical intraepithelial neoplasia (CIN) or invasive cervical carcinoma and 490 women without pathological changes in the cervical epithelium. The interviews was performed using a standardised questionnaire. The percentage of women who attended screening programmes for cervical carcinoma amounted to 83.5% for the study group and 81% for the control group. The relative risk (RR) for developing CIN or invasive cervical carcinoma increased with the use of hormonal contraceptives; the increase being statistically significant (RR = 3.5; p = 0.006). Moreover easy use of oral contraceptives (< 18 years, 18-20 years, 21-25 years vs > 25 years) and prolonged use of oral contraceptives were associated with a significant increased of the relative risk. In contrast, women who used IUD had a very low relative risk (RR = 0.6; p = 0.005). 54.5% of the patients in the study group and 41.6% of those in the control group were smokers. We observed that smoking increases the relative risk for cervical carcinoma or CIN (RR = 1.7; p = 0.01). The duration of smoking and the number of cigarettes smoked were observed to increase the risk for cervical carcinoma, the increase being statistically significant.

Adolescent↗
PubMed1994

[Results of a case-control study of the current effect of various factors on risk of cervix cancer. 1. Factors in reproduction, sex behavior and infectious genital diseases].

We performed a case control study to determine factors which influence the development of cervical carcinoma. Factors like reproduction, sexual behaviour and genital infections were considered. 309 patients with cervical intraepithelial neoplasia (CIN) or invasive cervical carcinoma were interviewed as a study group. 490 patients with no cervical changes served as control group. The two groups of patients had a different age distribution with an early age summit in the study group. No differences were observed in relation to residence areas and attendance of screening for cervical carcinoma. 83.5% of the women in the study group (n = 258) and 81.0% (n = 397) of the control group attended the screening for cervical carcinoma. According to our observation, the following factors increased the risk of CIN or invasive cervical carcinoma: early menarche (< 14 years vs > 14 years), multiparity (0 vs 1-3 vs > 4), first pregnancy before the age of 20, divorced women, early sexual contact (< 14-17 years vs 18-21 years vs > 21 years), multiple sexual partners, vaginal discharge and venereal diseases (gonorrhea, syphilis). Factors like reproductive characteristics and genital infections can be interpreted as expressions of sexual behaviour. Despite the improving social status, increasing health consciousness and extensive mass-screening for cervical cancer, the above mentioned risk factors still play an important role. Risk group should be followed and examined strictly so as to reduce the rate of invasive cervical carcinoma in screened patients.

Adolescent↗
PubMed1993

[Determination of steroid hormone receptors with the biochemical DCC method in endometrial cancer and tumor margin-endometrium relations to cellular changes and hormone level].

In endometrial carcinoma and the surrounding marginal endometrium from 48 postmenopausal patients, the concentrations and dissociation constants of steroid hormone receptors were studied by the dextran-coated charcoal method (DCC), parallel to ploidy and morphology of tumour cell nuclei, grading, and the hormonal status. The results show, that the proportion of receptor-positive tumours is decreased in an advanced stage of disease. The mean receptor concentrations correlate both with nuclei parameters and the morphological results and reflect the process of dedifferentiation in the tumour centre. The higher receptor concentrations, especially the estradiol receptor concentration observed in the marginal endometrium, and the increased estradiol level in serum, demonstrate a raised tendency to proliferation in this region and could support the hypothesis, that a higher receptor level in adenomatous-hyperplastic tissues participates in tumour genesis. In patients with an advanced stage of the disease, determination of both receptors can yield indications for a purposeful adjuvant hormone therapy (anti-estrogen and/or gestagen), in addition to providing an aid to prognosis.

Aged↗
PubMed1993

Mechanical dilatation rather than plaque removal as major mechanism of transluminal coronary extraction atherectomy.

Atherectomy with the transluminal extraction endarterectomy catheter (TEC) is a new approach for treatment of coronary artery disease, which continues to undergo FDA investigational studies. The major mechanism of the TEC device should be excision of plaque and its removal due to suction applied through an attached vacuum. We report about the acute results in 24 patients treated with TEC atherectomy in native vessels and the outcome of 18 patients who, until recently, underwent follow-up catheterization after 6 months. The procedure was successful (residual stenosis less than 50%) in 7 of 24 patients with TEC atherectomy alone (29%); 15 of 24 patients (65%) required additional PTCA in order to achieve angiographic success (10 of 24) or to treat total occlusion (2 of 24) or distal embolization (3 of 24) following atherectomy. One TEC attempt failed due to guiding catheter problems, another major complication was a vessel perforation leading to a non-Q wave infarction. The minimal residual diameter after passage of the stenosis (prior to additional PTCA) with the 5.5 Fr catheter (n = 14) was 1.5 +/- 0.2 mm, with the 6 Fr catheter (n = 9) 1.8 +/- 0.4 mm, and 2.2 +/- 0.2 mm using the 7 Fr catheter (n = 10). The histologic findings revealed intimal cells, fibrous tissue, and homogenate with no identifiable tissue in five cases (21%), whereas in 17 patients (72%) light microscopy could only assess blood cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

[Influence of nCPAP therapy on bradycardic arrhythmias in sleep apnea].

In 5-10% of patients with sleep apnoea, AV conduction block or sinus arrest up to several seconds can be demonstrated. We studied the effect of nCPAP treatment on apnoea-associated heart blocks. 10 consecutive patients (9 m, 1 f) between 28-56 years of age (mean value 43.4 y) were studied. The diagnosis of sleep apnoea and nocturnal heart blocks during the first visit at the outpatient department were the only selection criteria. A standard polysomnography before and during nCPAP was performed. Mean pretreatment RDI was 91/h. Repetitive II degrees and III degrees AV conduction blocks were diagnosed in 2 patients (pts) and sinus arrest of 2 to 11 s in 8 pts at the study without therapy. 89.2% of heart blocks occurred during REM-sleep. In 8 pts a complete reversal of heart blocks could be demonstrated during nCPAP. In 2 pts heart blocks persisted at a reduced number during REM-sleep, mainly during ineffective nCPAP. In 80% of our pts nCPAP leads to a complete reversal of heart blocks. The indication for pacemaker implantation must be established on an individual basis.

Adult↗
PubMed1992

The relation between the results of cytophotometric examination of endometrial carcinoma and clinical course of these disease.

We made a prospective cytophotometric study of 48 cases of endometrial carcinoma. Thirty-two (66.7%) of the cases had diploid DNA content and the proportion of non-diploid tumors increased with the staging of tumors, lack of differentiation and depth of myometrial invasion. DNA content (AE), DNA malignancy grade (DNA-MG) and 5c exceeding rate were statistically significant in relation to the clinical course of the disease and the histological grade of differentiation. DNA parameters appear to be especially suitable for the objective assessment of malignancy.

Adenocarcinoma↗
PubMed1992

[In-vivo 31P-NMR-spectroscopy in patients with dilated cardiomyopathy].

In vivo 31P-NMR spectra of heart muscle were obtained in 7 patients with dilating cardiomyopathies and in 10 normal subjects, using an ISIS technique with a 1.5 Tesla body scanner (Philips Gyroscan S15) and the results of the two groups were compared. These results were easily reproduced. In patients with cardiomyopathy there was a significant (p < 0.05) reduction of the PCr/ATP ratio as an expression of abnormal energy metabolism. Two patients with mild clinical symptoms and only slightly reduced functional measurements showed no significant changes in the 31P-NMR spectrum. The patients with the largest reduction of the PCr/ATP index also showed the most marked changes in functional measurements. The PCr/ATP ratio (as also suggested by animal experiments) appears to be a suitable non-invasive indicator for the diagnosis and staging of myocardial changes in dilating cardiomyopathies.

Adenosine Triphosphate↗
PubMed1992

[Posner-Schlossman syndrome].

The clinical features of Posner-Schlossman syndrome and the various differential diagnoses are described in a 20-year-old patient. Additional to Posner-Schlossman syndrome this patient showed signs of Axenfeld's anomaly. He also presented symptoms of a status-dysrhaphicus-like state after atrial septal defect and the ability to overstrain the distal finger joints. Posner-Schlossman syndrome, heterochromic cyclitis, anterior-chamber cleavage syndrome and ICE syndrome (iridocorneal-endothelial syndrome: Chandler's, Cogan-Reese syndrome and progressive essential iris atrophy) often produce similar effects at the Descemet membrane, the anterior chamber angle and the iris. Because of the same mesodermal origin of these tissues we suggest that all the diseases mentioned above are merely different clinical expressions of one main disease.

Adult↗
PubMed1992

[Transluminal coronary extraction atherectomy. Method, acute results, angiographic and clinical follow-up].

Transluminal coronary extraction-endarterectomy is an alternative interventional approach for treatment of coronary artery disease. The atherectomy system consists of a catheter assembly including a cutter and torque tube which is rotated at a relatively low rate of 750 rotations per minute, when introduced to the coronary artery over a guide-wire via a guiding catheter. Excised tissue is withdrawn from the coronary artery by suction applied through the catheter by means of an attached vacuum bottle. We report acute results in 18 patients and the clinical outcome of 14 patients who up to now underwent angiographic follow-up catheterization after 6 months. Initial angiographic success (residual stenosis less than 50%) using TEC-atherectomy alone was obtained in 6/18 patients (33%), 11/18 patients (60%) required additional PTCA in order to achieve primary success (9/18) or to treat total occlusion (2/18) after TEC-atherectomy. Major complications consisted in 1-vessel perforation with non-Q-wave-infarction but no need of surgical intervention and 2 occlusions due to dissection (treated with PTCA). 14 patients underwent angiographic follow-up (6 months) and restenosis (greater than 50%) was confirmed in 7 patients (50%). Considering the low primary success rate of TEC-atherectomy alone and the tendency to high restenosis rate, we cannot recommend it as an alternative to conventional PTCA in general clinical practice. Further studies should be designed to directly compare TEC-atherectomy to PTCA in specific patient subgroups (e.g. bypass grafts, intraluminal thrombus, diffuse disease) in order to define the role of this interventional device.

Adult↗
PubMed1991

[Scintigraphy with 123I-labelled fatty acids in coronary heart disease].

Forty-two patients (6 women, 36 men; mean age 55 [39-69] years), with one-, two- or three-vessel disease on coronary angiography, were studied using single-photon emission computer tomography with 15-p-123I-iodophenyl-pentadecanoic acid (IPPA), in order to evaluate this new method of demonstrating abnormalities of myocardial perfusion. The reference range for fatty acid turnover was determined in eleven controls (4 women, 7 men; mean age 41 [20-51] years) with no coronary stenosis. 185 MBq (5 mCi) of IPPA was administered intravenously during submaximal stress on a bicycle ergometer. Comparison between different regions of the tomograms revealed changes in fatty acid utilization typical of ischaemia. The sensitivity, specificity and predictive value of a positive result compared with coronary angiography were 95%, 89% and 93%, respectively, for the area supplied by the anterior interventricular artery, 92%, 91% and 93% for the circumflex branch and 89%, 91% and 90% for the right coronary artery. In 25 out of 31 patients (81%) with myocardial infarction, IPPA scintigraphy infarct localization agreed with the clinical findings. In two cases with unremarkable scintigrams left ventriculography showed hypokinesia, while in four cases neither method demonstrated any abnormality. There was one false-positive scintigram. IPPA scintigraphy has greater sensitivity and specificity than conventional nuclear medicine techniques in the demonstration of coronary heart disease.

Adult↗
PubMed1991

[A new instrument for measuring eyelid strength].

Former investigations concerning muscular eyelid strength with dynamic registration revealed great inter- and intraindividual variations. We tried to minimize these influences by using an electronic power register with isometric registration. This is important because lid closing is a complex mechanism of horizontal and vertical movements with continuously changing power vectors. Our new apparatus reduces false results. A normal collective of 114 persons was examined. The results show no statistically significant age- or sex-related differences in lid strength.

Eyelid Diseases↗
PubMed1991

[Degree of DNA ploidy and steroid hormone receptors as prognostic factors in endometrial carcinoma].

In a prospective investigation the concentration of DNA (ploidy) and of steroid hormone receptors (ER and PgR, resp.) were studied in endometrial carcinoma and related to each other, to established morphological prognostic criteria (stage, typing, grading, relative invasion of myometrium), and to the clinical progress of disease, respectively. The microscopic spectrophotometric analysis of DNA showed diploid main lines in 2/3 of investigated endometrial carcinoma. It could be demonstrated a relationship between heteroploidy, decreased mean concentrations of ER and PgR, unfavourable prognostic factors (stage II-IV, G3, myometrial invasion of greater than 2/3) and clinical progress of disease. The mean value of ER and PgR was higher in diploid carcinoma than in heteroploid ones. Significant differences were found both in the relation of the PgR concentration to different tumor stages (stage I vs. II-IV) and of the concentration to the different types of ploidy. Exceeding the histological differentiation, the determination of DNA and ER/PgR receptors can results in additional prognostic informations for a scientific proved, adjuvant or curative strategy of therapy after the operation.

Carcinoma↗
PubMed1991

[Morphologic studies of endometrial cancer for biological assessment of nuclear grading].

Three hundred and eighty-three cases of endometrial carcinoma stage pT1NxM0 had been reviewed retrospectively by making use of histo- and cytomorphological studies. The carcinomas were re-classified and histological and cytological gradings, independent from each other, have been carried out. Typical tumor characteristic of the nucleus (nuclear grading) and their biological importance have been described compared with morphological factors of prognosis (typing, histological grading, depth of myometrial invasion, lymph- and blood vessel invasion). Interrelations and discrepancies between histological and nuclear grading will also be described.

Adenocarcinoma↗
PubMed1991

[Results of a psycho-oncological project at the University Women's Hospital Leipzig].

This paper deals with a synoptic description of experiences of an inter-disciplinary oncologic project by means of its three main components--theoretical research, further education and qualification as well as psychological intervention program. It was shown that team work between physicians, nurses and psychologists led to an new insight and higher working effectivity with minimal subjective stress. This team work led also to the creation of favourable conditions for an appropriate management of diseases through an intensive and integrated patient care. The application of this model project in the routine oncological follow-up would be recommended.

Counseling↗
PubMed1991

[Cytophotometric studies for evaluating the prognosis in endometrial cancer].

This paper deals with a prospective cytophotometric study of specimens from 48 cases of primary endometrial carcinoma. The tumor material was obtained from the region of tumor invasion immediately after an operation and in 8 cases by fractional curettage after ultrasonographic localisation of the tumor. The specimens were air-dried and Feulgen stained. The cytophotometric examinations were performed with a scanning cytophotometer. A computer-assisted data registration and processing was carried out. The histological diagnosis of the tissue specimen and curettage specimen was established according to standardized criteria. 32 out of the 48 investigated cases of endometrial carcinoma were diploid. Observations conducted over a period of 12 months showed a partially significant correlation (u-test according to Mann and Whitney) between DNA-content and stage of the tumor (FIGO), histological grade of the tumor, relative depth of myometrial invasion as well as the clinical course. A differentiation based on the ploidy and the average relative DNA content (AE) in relation with typing is not possible. It was not possible to state the difference between average nuclear surface (F) and individual morphological variables. The average extinction, as a measure of the chromatin density, was determined for each specimen. A significant increase of the average extinction was established for carcinomas which infiltrated more than 2/3 of the uterine wall. Ploidy, average relative DNA content and average extinction provide an invaluable additional parameter in the assessment of the prognosis, post-operative therapy and aftercare of patients with endometrial carcinoma.

Adenocarcinoma↗